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Looking after your practice premises

Many GPs spend as much time in their surgeries as in their homes – so make sure your premises are pleasant and well maintained, says Dr John Couch

Many of us spend more than 80% of our working day in the warm bosom of our surgery premises. For full-time GPs this is 32 hours a week, 1,500 hours a year – over a 30-year career, a staggering 45,000 hours.

This is probably as much time as we spend during waking hours in our own homes. So how many of us take as good care of our premises as we should?Let's face it, there are still many surgeries with poor or substandard buildings, partly because of poor NHS funding but also because of reluctance to spend profits on our workplaces. Should there be such a stark contrast between home and work?Although more than half of practices now work from rented premises, the general principles of establishing a decent workplace are the same for all. It is worth spending a few structured hours ensuring your premises are fit for purpose and that you have a sensible rolling programme for maintenance and refurbishment. Start with your insurance – buildings and contents for owners, contents-only for those who rent. Every two years, get three competitive quotes ensuring you compare like-for-like cover. Remember to insure for up-to-date rebuilding costs rather than the value of your premises, as this is cheaper. Ensure that you have subsidence cover and, if changing companies, retrospective cover. Some policies offer income tax investigation protection as a perk.Check the value of your current contents before renewal or new policy quote. Also ensure that you have third-party liability included. Now cast a critical eye over the internal and external condition of the building. Are there any urgent repair or maintenance issues such as blocked gutters or drains? When will external painting be required? Which rooms are most in need of redecoration? Does your boiler need servicing? Do sinks, taps, lavatories or wiring require attention? Are any fittings or furnishings ready for death certificates? Make a list and prioritise.Next, address planning issues. Do any rooms need refurbishing for change of use? Has the political climate changed for your desired extension, rebuild or premises move? There is little to be lost by a few telephone calls to the PCT, planning department or a private developer to find out.Your list is likely to be a long one. Divide items into urgent, important and routine. Then create a priority list in each group. Cost urgent items for action this year.Renters should inform their landlord of relevant external problems. Some of the items may just attract that near-extinct creature, the PCT grant. At any rate, you lose nothing by asking. Occasionally practices receive patient gifts or bequests, often conditional on being used for patient benefit. Some items will fall into this category, allowing expenditure with good conscience. Prescribing incentive money falls into the same category. If partners have no choice but to use practice profits, try to spread the load over the whole year. If you require a loan it will attract business use tax relief. Finally, always have a small premises contingency fund to cover unforeseen expenditure.If your premises are falling apart around you, do something about it. Well-kept premises can lift the heart, improve staff morale, satisfy patients and even make arriving at work on a Monday a pleasure.

Dr John Couch is a GP in Ashford, Middlesex

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